Table 4.

Seven samples (six patients) with discordant results between the different methods

Patient	Microscopy	Parasitaemia by microscopy	18S PCR assays	Mitochondrial PCR/sequencing	Primary/recurrent infection	Place of infection	Interpretation
P 1	Negative	01	Pm	Pm	Primary	Ghana	Pm overlooked by microscopy
P 2	Negative2	01	Pv	Pv	Primary	New Guinea	Pv overlooked by microscopy
P 2	Pf, Pv or Pk	1%	Pv	Pv	Recurrent (Relapse)	New Guinea	Inconclusive/ incorrect diagnosis by microscopy
P 3	Pf + Po	<1%	Po	Po	Recurrent (Relapse)	Uganda	Over-diagnosed mixed infection by microscopy
P 4	Pf	<1%	Pf + Pm	Pf	Primary	Liberia	Under-diagnosed mixed infection by microscopy/sequencing
P 5	Pf + Pv	1%	Pv	Pv	Primary3	SEA or CA	Over-diagnosed mixed infection by microscopy
P 6	Pf 4	<1%	Negative	Pf	Recurrent (Recrudescence)	Guinea	Un-detected low Pf parasitaemia by 18S PCR

Abbreviations: Pf, Plasmodium falciparum; Pv, Plasmodium vivax; Po, Plasmodium ovale; Pm, Plasmodium malariae; Pk, Plasmodium knowlesi; SEA, South east Asia; CA, Central America.

¹ Not detected any parasites.

² Positive microscopy two days later (1% parasitaemia) and then the patient was diagnosed with severe malaria and treatment initiated.

³ Not given hypnozoite-eradicating treatment and re-admitted four weeks later with relapse of Plasmodium vivax.

⁴ Only one parasite detected.